Department of Obstetrics and Gynaecology, Würzburg University Medical Centre, Würzburg, Germany.
Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
PLoS One. 2019 Jul 8;14(7):e0218434. doi: 10.1371/journal.pone.0218434. eCollection 2019.
In this study based on the BRENDA data, we investigated the impact of endocrine ± chemotherapy for luminal A, nodal positive breast cancer on recurrence free (RFS) and overall survival (OS). In addition, we analysed if tumor size of luminal A breast cancer influences survival in patients with the same number of positive lymph nodes.
In this retrospective multi-centre cohort study data of 1376 nodal-positive patients with primary diagnosis of luminal A breast cancer during 2001-2008 were analysed. The results were stratified by therapy and adjusted by age, tumor size and number of affected lymph nodes.
In our study population, patients had a good to excellent prognosis (5-year RFS: 91% and tumorspecific 5-year OS 96.5%). There was no significant difference in RFS stratified by patients with only endocrine therapy and with endocrine plus chemo-therapy. Patients with 1-3 affected lymph nodes had no significant differences in OS treated only with endocrine therapy or with endocrine plus chemotherapy, independent of tumor size. Patients with large tumors and more than 3 affected lymph nodes had a significant worse survival as compared to the small tumors. However, despite the worse prognosis of those, adjuvant chemotherapy failed in order to improve RFS.
According to our data, nodal positive patients with luminal A breast cancer have, if any, a limited benefit of adjuvant chemotherapy. Tumor size and nodal status seem to be of prognostic value in terms of survival, however both tumor size as well as nodal status were not predictive for a benefit of adjuvant chemotherapy.
在这项基于 BRENDA 数据的研究中，我们调查了内分泌治疗±化疗对腔 A 型、淋巴结阳性乳腺癌患者无复发生存（RFS）和总生存（OS）的影响。此外，我们还分析了在淋巴结阳性数目相同的情况下，腔 A 型乳腺癌的肿瘤大小是否影响患者的生存。
本回顾性多中心队列研究分析了 2001 年至 2008 年间诊断为腔 A 型乳腺癌的 1376 例淋巴结阳性患者的数据。结果根据治疗方案进行分层，并通过年龄、肿瘤大小和受累淋巴结数目进行调整。
在我们的研究人群中，患者的预后良好至极好（5 年 RFS：91%，肿瘤特异性 5 年 OS：96.5%）。仅接受内分泌治疗和内分泌联合化疗的患者 RFS 无显著差异。仅接受内分泌治疗或内分泌联合化疗的 1-3 个受累淋巴结的患者，无论肿瘤大小如何，OS 均无显著差异。肿瘤较大且受累淋巴结超过 3 个的患者，与肿瘤较小的患者相比，生存状况显著较差。然而，尽管预后较差，但辅助化疗并未能改善 RFS。
根据我们的数据，淋巴结阳性的腔 A 型乳腺癌患者，如果有任何获益，辅助化疗的获益有限。肿瘤大小和淋巴结状态似乎与生存预后相关，但肿瘤大小和淋巴结状态均不能预测辅助化疗的获益。
